Inhuman And Unconscionable

Our View: An Agreement Between Officials And Prisoners' Rights Groups Over Medical Care At The City Jail Ensures Inmates Live Long Enough To Pay Their Debt To Society

August 20, 2009

While Americans spent much of the August doldrums transfixed by the national debate over health care reform, state officials moved toward resolution of a long-running dispute involving the medical care inmates receive at the 150-year-old Baltimore City Detention Center. This week, officials announced a settlement in a lawsuit originally brought in 1971 aimed at ensuring jail inmates get adequate medical treatment for illnesses such as asthma, diabetes and infectious diseases, and that they are not held in facilities rife with safety hazards and vermin.

The agreement reached between prisoners' rights advocates and the state, which operates the Baltimore detention facility, will by no means result in Cadillac health care for the inmates incarcerated there. But being tough on crime shouldn't mean putting prisoners' lives at risk through blatantly inadequate medical care and woefully unsanitary conditions.

As the lawsuit made its way through the courts, it threw a spotlight on an appalling situation in which inmates were locked up in insect- and rodent-infested cells with backed up sewage and malfunctioning heating and air-conditioning systems that left them sweltering in summer and freezing in winter.

The suit documents cases in which a diabetic inmate died for lack of an insulin injection and an asthmatic man was allowed to die because his jailers thought he was malingering and refused to provide him with an inhaler.

By no stretch of the imagination can these cruelties be described as humane treatment. At worst, documented acts of deliberate degradation, such as guards kicking female inmates who collapsed from the heat to see whether they were still alive, approached a level of callousness seldom seen outside the context of major human rights abuses. Some prisoners' stories about the mistreatment they endured make the jail sound more like a medieval dungeon than a modern American correctional facility.

Why did it take officials so long to acknowledge this horrendous state of affairs and move to correct it? The answer seems to be a combination of bureaucratic inertia and lack of resources. As a result of the original lawsuit the state did enter into a consent decree as far back as the mid-1970s, under which it agreed to make efforts to comply with minimum health and safety standards for inmates. But progress was slow and the decree was revised in 1993 and again in 2003, after Congress passed the Prison Litigation Reform Act of 1995, which made it harder for inmates to sue over the conditions under which they were held and more difficult for judges to enforce existing consent decrees. Since 2002, the federal Justice Department has been monitoring the state's compliance with more than 100 categories of complaints, including health care, safety hazards, overcrowding and inmate education.

Prisoner rights have never been at the top of politicians' agendas, and that was especially true during the early decades of the case in the 1970s and '80s, when being seen as tough on crime was a virtual requirement of any successful campaign for public office. An unconscionable situation was allowed to fester even after it became apparent reform was urgently needed. This week's settlement represents yet another commitment by the state to ensure inmates at the jail receive a standard of basic medical care and safety demanded by a civilized society. It shouldn't take another 40 years for Maryland to begin realizing that goal.